Friday, April 26, 2013

Critically Thinking about Research: (Thoughts on Autism)

(EcoYogini discusses the misrepresentation of medical research in the media, the environmental aspect of health and the importance of critically thinking about medical research)

My day job (or alternate identity) is a paediatric Speech-Language Pathologist. I love my job, I get to work with families of children with a variety of disorders, delays and diagnoses. I spent two years as part of the Autism Team in British Colombia and loved every single minute of working with such fabulous families.

Communication is such an integral part of every single thing we do as humans. It forms the basis with how we interact with others, the language and associated memories and feelings we have with words shape how we think and perceive our world. Language skills are also essential for academic success. Finally, integral for emotional attachment and connection between parent and child, communication becomes one of the priorities in early childhood.

Because of this, you can understand how parents and caregivers would do or give anything to help their children communicate. Unfortunately, there are many organizations and programs that would capitalize on this need in order to make a profit from their vulnerability.

It's so unfair to expect parents and caregivers, who often are reeling from a recent diagnosis and shift from 'my child's future without_____' to 'my child's future with_____', to take the time to wade through scientific research, claims and evidence based practice. That's our job as professionals.

But often, professionals are quick to scoff at any sort of alternative treatment. Mostly because so many of them are scams, cost money or require huge changes in lifestyle. However, I feel that as professionals we need to listen with an open heart and mind, and give unbiased perspectives and recommendations after investigation and careful thought.

(there's a link to the environment coming up, truly!)

For example, recently there has been a research study discussed in the media regarding 'creases in the placenta' and a 'link' (NOT causation) to Autism. Honestly, the media has a terrible history of incorrectly interpreting or reporting medical research.

The researchers actually studied the placentas of the second child of families with a child already diagnosed with Autism (and as such are already at higher risk for a second child who will be diagnosed). Important to note: the differences in placenta were NOT 100% across mothers. Differences were noted as higher levels of 'trophoblasts' on the placenta, which researchers are clear to state do not, to scientific knowledge to date, affect the neurodevelopment of the child. Further, the researchers found a correlation for non-genetic RISK marker of Autism and not Autism itself (which, these children were already identified as higher risk due to their sibling with a diagnosis).

What is interesting about this study, is the potential for earlier diagnosis, or at least earlier flagging children who may be at risk for a later diagnosis of Autism or other developmental disorders. This is a positive thing because of the placement of earlier intervention ("speech therapy" should be renamed 'communication therapy' and can be helpful before the child actually begins speaking).

The risk, of course, is the mis-labeling of children at risk and use of intervention unnecessarily. (I am not of the idea that we could overdiagnose Autism. At least not in Canada, as a diagnosis is extremely intense, involves an entire team of professionals and due to the money attached to a diagnosis is NOT done lightly).
What is interesting about this study is the mention that the higher trophoblasts on the placenta could be caused by a variety of environmental triggers, including endocrine disrupting chemicals in the mother's environment. Unsurprisingly, I am of the mind that we currently have no idea the extent the chemical soup in our daily lives are affecting our health, and our children's health.

That said- it's so so important to recognize that this is an INITIAL study, further study and research is necessary AND we really can't link developmental disorders or Autism ONLY to our exposure to environmental toxins and chemicals. We just can't.

As citizens, parents and professionals we can just be aware of the research being done, take all news reports (including this blog post!) with a grain of salt and discuss questions and concerns with a trusted health professional.

AND Especially be EXTREMELY weary of any treatment, claims (ie 'placenta health!'), health regimes and products that would require a monetary investment.